LWW

Special Report:  H1N1 Update from NursingCenter

Let us help you stay updated about H1N1 influenza. Review key facts, stay in-the-know about WHO alerts, get the latest drug recommendations for treatment and prophylaxis, and more.

Lisa Bonsall, MSN, RN, CRNP
NursingCenter.com's Clinical Editor
Key Facts about H1N1 influenza

 

 

  • H1N1 is a respiratory illness caused by type A influenza viruses.
  • Transmission may occur in similar ways that other flu viruses spread, such as through coughing or sneezing, or touching something with the virus on it and then touching one's mouth or nose.
  • A person cannot get this new HIN1 virus from eating pork or pork products.
  • Symptoms of H1N1 include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue, diarrhea, and vomiting.

Back to top

 

H1N1 Vaccines

 

 

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) recommends that the following groups be vaccinated against H1N1 influenza:

  • pregnant women
  • people who live with or care for children less than 6 months old
  • health care and emergency services personnel
  • people between the ages of 6 months through 24 years of age
  • people ages 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems

In the event of a vaccine shortage, the ACIP recommends that the following groups receive the vaccine before others:

  • pregnant women
  • people who live with or care for children less than 6 months of age
  • health care and emergency services personnel with direct patient contact
  • children between 6 months and 4 years of age
  • children ages 5 through 18 years of age who have chronic medical conditions

To decrease the incidence of secondary pneumococcal pneumonia, the CDC is also recommending prophylactic administration of 23-valent pneumococcal polysaccharide vaccine (PPSV23) during the outbreak of novel influenza A(H1N1). The recommendations of the CDC's Advisory Committee on Immunization Practices (ACIP) are as follows:

  • Vaccination for all persons over 65 years of age
  • Vaccination for persons 2 to 64 years with the following medical conditions:
    • Chronic cardiovascular disease (congestive heart failure and cardiomyopathies)
    • Chronic pulmonary disease, including COPD and emphysema
    • Diabetes mellitus
    • Alcoholism
    • Chronic liver disease, including cirrhosis
    • Cerebrospinal fluid leaks
    • Functional or anatomical asplenia, including sickle cell disease and splenectomy
    • Immunocompromised conditions, including HIV infection, leukemia, lymphoma, Hodgkin's disease, multiple myeloma, generalized malignancy, chronic renal failure, nephrotic syndrome; those receiving immunosuppressive chemotherapy (including corticosteroids); and those who have received an organ or bone marrow transplant
  • Vaccinations for persons 19 to 64 years who have asthma or smoke.

*Note: A single revaccination at least five years after initial vaccination is recommended for people 65 years and older who were first vaccinated before age 65 years as well as for people at highest risk, such as those who have no spleen, and those who have HIV infection, AIDS or malignancy.

 

Back to top

 

H1N1 Treatment

 

 

The CDC has outlined specific antiviral guidelines for prevention and treatment of confirmed, probable, and suspected cases of patients with H1N1 influenza and their close contacts.

Current antiviral dosing recommendations are as follows:

oseltamivir (Tamiflu)

To prevent H1N1 influenza.
Adults: 75 mg capsule by mouth (P.O.) once daily for 10 days
Children 12 months and older weighing greater than 40 kg: 75 mg P.O. once daily for 10 days
Children 12 months and older weighing 23 kg to 40 kg: 60 mg P.O. once daily for 10 days
Children 12 months and older weighing 15 kg to 23 kg: 45 mg P.O. once daily for 10 days
Children 12 months and older weighing 15 kg or less: 30 mg P.O. once daily for 10 days
Infants 6 to 11 months: 25 mg P.O. once daily for 10 days
Infants 3 to 5 months: 20 mg P.O. once daily for 10 days
Infants less than 3 months: Not recommended unless situation judged critical due to limited data in use in this age group.

To treat H1N1 influenza.
Adults: 75 mg capsule P.O. twice daily for 5 days
Children 12 months and older weighing greater than 40 kg: 75 mg P.O. twice daily for 5 days
Children 12 months and older weighing 23 kg to 40 kg: 60 mg P.O. twice daily for 5 days
Children 12 months and older weighing 15 kg to 23 kg: 45 mg P.O. twice daily for 5 days
Children 12 months and older weighing 15 kg or less: 30 mg P.O. twice daily for 5 days
Infants 6 to 11 months: 25 mg P.O. twice daily for 5 days
Infants 3 to 5 months: 20 mg P.O. twice daily for 5 days
Infants less than 3 months: 12 mg P.O. twice daily for 5 days

Click here for complete prescribing information for oseltamivir (Tamiflu).

zanamivir (Relenza)

To prevent H1N1 influenza.
Adults: Two 5 mg inhalations (10 mg total) once daily for 10 days
Children 5 years and older: Two 5 mg inhalations (10 mg total) once daily for 10 days

To treat H1N1 influenza.
Adults: Two 5 mg inhalations (10 mg total) twice daily for 5 days
Children 7 years and older: Two 5 mg inhalations (10 mg total) twice daily for 5 days
 
 

Back to top

 

Patient Education

 

 

You may be hearing a lot about H1N1, not only through the media, but also from the patients that you are seeing in your practice. Login to access our new printable patient education guide to educate yourself and your patients about influenza A(H1N1). This tool is available to you in English and Spanish, courtesy of Lippincott's NursingCenter.com and Anatomical Chart Company. Not yet a member of Lippincott's NursingCenter.com? Join now!

 

Back to top